1. Technical Field
The present disclosure relates generally to the field of endoscopic surgical devices. More specifically, the present disclosure relates to an endoscopic fastener applying device for repairing torn tissue such as torn meniscus tissue.
2. Background of Related Art
One known technique for repairing torn meniscus tissue involves the use of a pair of surgical needles which are inserted through cannuli into the knee on opposite sides of a meniscal tear. The ends of the needles include a length of suture material which is pushed down through the cannuli and across the tear. An incision is made in the skin at the point where the needle exits the knee joint so that the leading end of each needle may be grasped and pulled through the joint. The ends of the sutures are then grasped after the needles are removed from the suture ends and the suture is then tied so that a horizontal suture is created in the meniscus. This procedure is repeated for placement of as many sutures as necessary to repair the meniscus tear. As is apparent, this process is both time consuming and difficult to effect.
A subsequent improvement over this procedure is outlined in U.S. Pat. No. 5,002,562, the contents of which are incorporated herein by reference. In this procedure, a barbed clip and an instrument for applying the clip are utilized. The instrument has a pair of opposed arcuate jaws which are shaped to hold a complementary-shaped curved surgical clip therebetween, such that the barbs of the clip are retained within notches in the jaws until the clip is inserted. The legs of the clip are joined by a flexible suture material. The jaws are biased in a normally open position, and as the jaws are pushed into the tissue, the jaws are scissored or closed together until they preferably overlap to move the legs of the clip together until they cross. The jaws are then reopened and backed out of the tissue, with the barbs of the clip retaining the clip in position in the tissue.
A further refinement to meniscal repair is illustrated in U.S. Pat. No. 5,997,552, the contents of which are incorporated herein by reference. This patent details a meniscal fastener applying device which applies fasteners sequentially from a longitudinally extending magazine. An advancing mechanism is operatively associated with an elongated body portion of the device for sequentially advancing surgical fasteners from a fastener supply to a firing position in alignment with a firing mechanism. The fastener includes a pair of anchor members whose proximal-most ends are connected by a suture material offset from the central longitudinal axis thereof. Because of the parallel over-under orientation of the firing mechanism and the longitudinally extending fastener magazine, the elongated body portion of the device requires a substantial cross-sectional area and necessarily requires a correspondingly wide distension of the knee joint to access the meniscal tissue to be repaired.
A single shot meniscal repair device is provided which incorporates a minimally sized elongate body portion configured to hold a single fastener adjacent a distal end thereof. The elongate body portion is part of a disposable loading unit structure which facilitates up to 360xc2x0 rotation about the longitudinal axis of the elongate body portion. In an alternate embodiment, at least a distal portion of the elongate body portion is angled off axis to enhance the versatility of the device. The fastener applied by the device includes a pair of anchor members interconnected by a flexible material. The flexible material extends from a respective side of the anchor members, thus maintaining the proximal ends thereof clear to receive the full driving force from the firing assembly without the risk of damaging the connecting flexible material.